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Surgical guide of a bone graft: closing and positioning system

Cutting guidesFibula free flapMandible reconstructionMaxillofacial surgerySurgical guides

Introduction

The mandible reconstruction with fibula free flap involves the use of two surgical guides: a cutting guide to remove the tumour or infection in correspondence of the lower jaw and a guide to harvest the fibula free flap. The fibula cutting guide’s closure system and the synergistic use of two guides allow placing the fibula flap correctly into the recipient site during the reconstructive surgical phase.

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Technical features

Mandibular defects, due to tumours or infections, irreversibly compromise the functional and aesthetic characteristics of the bone. To date, the best choice for mandible reconstruction involves grafting a fibula flap to replace the damaged bone portion. The mandible cutting guide and the fibula cutting guide identify the osteotomies position and orientation; during the bone resection operation, the surgeon leans the cutting tool blade against the guide. The shape of the two shells of the mandible cutting guide and the linking element allow to place the surgical guide on the bone correctly. Using the closure system present on the fibula cutting guide the surgeon approaches the fibula flap segments and locks them with a proper device. Finally, the surgeon assembles the two guides, equipped with appropriate reference elements, and inserts the flap inside the mandible.

TRL: 5

Possible Applications

  • Oral and maxillofacial surgery

Advantages

  • Customized surgical guides
  • Fast and unambiguous positioning of the mandible cutting guide
  • Keeping the healthy mandibular parts in position at the end of defect removal
  • More accurate positioning of the fibula flap segments
  • Shorter intervention time